Introduction
This is one of the common condition - a child with constipation may have bowel movements less frequently than normal, hard bowel movements, or large, difficult, painful bowel movements.

What do you see – Presentation
Pain a child may delay moving their bowels if they do not have a place where they feel comfortable having a bowel movement, or if they are busy and ignore the need to use the toilet. When the child does have a bowel movement, it can be painful and lead them to withhold (avoid going) in an effort to avoid more pain.

When I see such patients, I find…..
On occasion, a child may develop a tear in the anus (anal fissure) after passing a large or hard bowel movement. The pain from the tear can lead to with-holding. Barium enema test has to be done.

Treatment why...?...when..?
Treatment is recommended if your child has hard or painful stools. Treating pain early can help prevent your child from withholding, which can lead to chronic constipation.